Journal of critical care
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Journal of critical care · Aug 2015
ReviewPharmacologic prevention and treatment of delirium in intensive care patients: A systematic review.
The purpose of the study is to determine if pharmacologic approaches are effective in prevention and treatment of delirium in critically ill patients. ⋯ The use of antipsychotics for surgical ICU patients and dexmedetomidine for mechanically ventilated patients as a preventive strategy may reduce the prevalence of delirium in the ICU. None of the studied agents that were used for delirium treatment improved major clinical outcome, including mortality.
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Journal of critical care · Aug 2015
Safety profile and feasibility of early physical therapy and mobility for critically ill patients in the medical intensive care unit: Beginning experiences in Korea.
To evaluate risk factors for potential safety events during mobility physical therapy sessions in the medical intensive care unit. ⋯ Early mobility physical therapy performed by a newly established group was feasible for critically ill patients in Korea. However, potential safety events need to be monitored carefully for patients with extracorporeal membrane oxygenation support.
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Journal of critical care · Aug 2015
Review Meta AnalysisAssociations of fluid overload with mortality and kidney recovery in patients with acute kidney injury: A systematic review and meta-analysis.
Fluid resuscitation is commonly administered to maintain adequate renal perfusion in critically ill patients to prevent or even treat acute kidney injury (AKI). However, recent studies show that fluid overload is common and might be associated with poor outcomes in patients with AKI. Hence, the objective of this study was to assess the associations of fluid overload with mortality and kidney recovery in patients with AKI. ⋯ Fluid overload is associated with an increased risk of mortality in patients with AKI. The evidence of the relationship between fluid overload and kidney recovery is insufficient.
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Journal of critical care · Aug 2015
ReviewEarly mobilization in the critical care unit: A review of adult and pediatric literature.
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. ⋯ Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations.
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Journal of critical care · Aug 2015
Multicenter Study Observational StudySerum melatonin levels are associated with mortality in severe septic patients.
Melatonin in septic patients has been scarcely explored and only in studies of small sample size (maximum 20 patients). Thus, the objective of this study was to determine whether serum melatonin levels are associated with severity, oxidant and inflammatory state, and mortality in a large series of septic patients. ⋯ The novel finding of our study was that serum melatonin levels are associated with mortality in septic patients.